Abstract
IntroductionDespite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. ObjectivesThis investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. MethodsObservational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1+HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1+CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1+CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. ResultsCompared to the CI1+HA, CI1+CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio=4.38, 95% confidence interval – 95%=1.07–17.93, p=0.04). ConclusionsThe children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.
Highlights
Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear
We identified factors associated with the outcomes of sequential bilateral Cochlear Implantation (CI) (CI1 + CI2), including age at first implantation, inter-implant interval, Categories of Auditory Performance (CAP) score evaluated with the bimodal condition before the second CI, and various comorbidities of patients
Compared to bimodal scores (CI1 + HA), sequential bilateral CI provided significantly better audiological benefit based on CAP scores
Summary
Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Children with unilateral Cochlear Implants (CIs) have shown excellent speech perception abilities in controlled listening environments such as a quiet room or a sound-proof booth.[1]. Several studies have shown the benefits of bimodal rehabilitation[4] or bilateral CI5,6 compared to monaural listening with only one CI.[7] bimodal fitting and bilateral CI are accepted as safe and Benefit and predictive factors of pediatric bilateral CI effective methods with bilateral auditory stimulation to achieve better speech/language outcome.[8]
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